Data_Sheet_1_Association between dietary antioxidant quality score and severity of coronavirus infection: a case–control study.PDF

The purpose of this study was to examine the association between the dietary antioxidant quality score (DAQS) and the severity of Coronavirus disease 2019 (COVID-19). The present case–control study was carried out on 295 patients diagnosed with COVID-19 (≥18 years old), including 104 critical patients (Intensive care unit [ICU] admission) and 191 COVID-19 patients without severe complications (Non-intensive care unit [Non-ICU] patients) as cases. Dietary intake was assessed by a 147-item, semi-quantitative food frequency questionnaire (FFQ). Logistic regression was performed to calculate the odds ratio (OR) and 95% confidence interval (CI) for the considered risk factors. Our outcomes (after multivariate adjustment) suggested that higher adherence to DAQS was significantly associated with a decreased risk of COVID-19 infection severity (OR = 0.12; 95% CI: 0.04–0.29, p < 0.001). Similar results were seen when analyzed by sex [men (OR = 0.02; 95% CI: 0.002–0.15, p < 0.001) and women (OR = 0.21; 95% CI: 0.06–0.68, p = 0.012)]. A significant association between vitamin D3 intake and decreased risk of COVID-19 severity (OR = 0.91; 95% CI: 0.89–0.94, p < 0.001) was also observed. Moreover, multivariate results revealed that there were no significant associations between vitamin C (OR = 1.00; 95% CI: 0.99–1.00, p = 0.067), vitamin E (OR = 0.98; 95% CI: 0.86–1.11, p = 0.798), zinc (OR = 1.02; 95% CI: 0.86–1.20, p = 0.805), and selenium (OR = 0.99; 95% CI: 0.99–1.00, p = 0.077) intakes with the risk of COVID-19 severity. However, subgroup analyses by sex suggested a significant association between vitamin C intake and the risk of COVID-19 infection severity in women (OR = 1.00; 95% CI: 1.00–1.00, p = 0.028). Our findings showed a negative association between DAQS adherence and the risk of COVID-19 infection severity. Our results may be used to develop potential dietary therapies to decrease COVID-19 severity.

本研究旨在探讨膳食抗氧化质量评分（dietary antioxidant quality score, DAQS）与2019冠状病毒病（Coronavirus disease 2019, COVID-19）病情严重程度之间的关联。本病例对照研究纳入295名确诊COVID-19的成年患者（年龄≥18岁），其中104例为需入住重症监护病房（Intensive care unit, ICU）的重症患者，191例为无严重并发症的非ICU患者，以此作为研究病例。采用147条目半定量食物频率问卷（food frequency questionnaire, FFQ）评估受试者的膳食摄入情况。通过logistic回归分析计算各关注危险因素的比值比（odds ratio, OR）及95%置信区间（confidence interval, CI）。经多变量校正后的分析结果显示，更高的DAQS依从性与COVID-19感染病情加重风险显著降低相关（OR=0.12；95%CI：0.04–0.29，p<0.001）。按性别分层分析亦得到相似结果：男性群体（OR=0.02；95%CI：0.002–0.15，p<0.001）与女性群体（OR=0.21；95%CI：0.06–0.68，p=0.012）均呈现该负相关关联。此外，本研究还观察到维生素D3摄入与COVID-19病情加重风险降低存在显著关联（OR=0.91；95%CI：0.89–0.94，p<0.001）。多变量分析结果显示，维生素C（OR=1.00；95%CI：0.99–1.00，p=0.067）、维生素E（OR=0.98；95%CI：0.86–1.11，p=0.798）、锌（OR=1.02；95%CI：0.86–1.20，p=0.805）及硒（OR=0.99；95%CI：0.99–1.00，p=0.077）的摄入与COVID-19病情加重风险无显著统计学关联。不过，按性别进行的亚组分析表明，女性人群中维生素C摄入与COVID-19感染病情加重风险存在显著关联（OR=1.00；95%CI：1.00–1.00，p=0.028）。本研究结果证实，DAQS依从性与COVID-19感染病情加重风险呈负相关。上述发现可为开发用于降低COVID-19病情严重程度的潜在膳食干预疗法提供科学依据。